Manual Therapy: Helpful, Harmful, or Just Temporary?

By: Kelsie Mazur, DPT

“Can you just massage it?”

I hear this a lot, and I understand where it comes from. Manual therapy has a reputation for being the quick fix. Whether it's a deep tissue release, a joint pop, or some hands-on work that feels like it resets the body, many people expect that this is the best way to feel better fast. And to be fair, sometimes it does help. But the reality is more nuanced.

As a physical therapist, I don’t typically rely on passive treatments like manual therapy. I’ve found that movement, education, and strength-based approaches tend to create better long-term results. That said, there are moments where manual therapy has its place. It can be useful, it can be overused, and it’s often misunderstood. Let’s talk about where it fits in and why I approach it the way I do.

What is manual therapy?

Manual therapy is any hands-on technique a therapist uses to help with pain or mobility. This includes things like soft tissue work, joint mobilizations, spinal manipulations, and trigger point release.

The key thing to understand is that these techniques are passive. They’re done to your body, rather than involving you in the process. That matters when we’re trying to create lasting change, because the real improvements come from what your body learns to do, not just what happens to it.

When manual therapy helps

There are definitely times when manual therapy can make a difference. For someone in acute pain, it can help calm things down. If a joint or muscle is guarded or stiff, some hands-on work might allow better movement and make exercise more tolerable. It can also help reduce fear and build trust, especially at the start of care when someone is just trying to feel better and feel safe moving again.  In situations like that, I’ll sometimes use manual therapy as a way to open a door. It can give us a little relief, a little mobility, and a chance to move more effectively. And that’s valuable.

When it’s not enough

The problem is that manual therapy often becomes the main thing people expect, or the only thing that’s done. That’s when it can start to hold someone back. Its effects usually don’t last. It doesn’t address the root causes of pain, like strength deficits, movement habits, or how someone loads their body. And it can lead people to feel like they need someone else to fix them every time something hurts. Over time, that creates dependence and frustration.

If a treatment plan is built mostly around passive care, progress tends to stall. What gets people better is active work, not lying on a table!

Where I stand

My goal is to help people feel strong, capable, and in control of their recovery. That’s why I focus on education, movement, strength, and body awareness. These are the things that lead to lasting improvement. That said, I’m not against manual therapy. There are situations where it helps, and I’ll use it if it supports your ability to move and engage in more active strategies. I just don’t rely on it as the foundation of care. It’s a tool I might reach for in specific moments, but not something I build an entire plan around.

What I tell my patients

When someone comes in expecting hands-on treatment, I’m always upfront about how I approach care. I’ll explain if and why we might use manual therapy, and I’ll also talk through why we’re focusing more on movement or strength. Most people appreciate understanding the reasoning behind their care. And once they start to feel stronger and more independent, they usually don’t miss the manual work.

Final thoughts

Manual therapy isn’t harmful and it isn’t magic. It’s just one tool in my tool kit among many. When used at the right time and in the right way, it can support recovery. But it’s not the solution on its own. If you’re dealing with pain or injury, ask yourself whether your care is helping you build lasting resilience or just providing temporary relief. The goal should always be long-term progress, not just short-term comfort.

Let’s focus on what actually moves the needle, and that usually starts with movement.

Let’s chat. Book an assessment and let’s get you back to feeling good in your body.
No referrals, no waiting, just answers. Did you know that we offer free 1-on-1 injury screens? Wattage Physical Therapy will take an in depth look at your ergonomics, posture, muscle tone, muscle weaknesses, and movement patterns to create a plan for YOU. If this article intrigues you, you can directly email me, Kelsie at Kelsie@wattagept.com. I would be happy to help you start the process of living a life free from pain.